HomeMy WebLinkAboutDrain Layers Permit 375 Benedict Drive (2) TOWN OF '`SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT
p 515
Dwn- 14 19n 119
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 5 aft"tct Dr. on the
=aside, between >2!!ti*V & 8
at premises owned by ` �itlPt` +3
whose address is ass
and to _)( Lay House Drain, Repair House Drain, Lay-Main, Other
for j*W-d j occupancy or use,
with rma Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( X}, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with air izsb (6) A-tatinive
Permit to be issued to rr&jrk MIM
the holder of Drain Layer's License No. t - M I3 Permit will expire on F*b* 7 ig 73 .
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS �S UY*fir tO Ms Or"& Md b*Okfi 3. "Pti*
Signed
Connection Charge Paid pz Licensed Drain Layer
Slav So JIM4 Issued by Ulph A $t&rky*Rt i" Jr*
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: _
INITIAL (Sig)
FINAL ). t r;�P7 i (Sig)
�� f• R
APPROVED- (Date)
(Sig)
INSPECTOR